RESUMEN
OBJECTIVE: To determine the noun for 'women who attend antenatal clinics' that is most accepted by the women themselves. DESIGN: Cross sectional study. SETTING: Consultant-led antenatal clinics in Cornwall. POPULATION: All women attending consultant-led antenatal clinics over a two-month period. METHODS: The women were surveyed by written questionnaire. MAIN OUTCOME MEASURES: The first, second and third choices of descriptions offered to women attending antenatal clinics. Secondary outcome measures include the relation of maternal age, gestation, civil status, occupation and obstetric history to the individual's choice of description. RESULTS: Questionnaires were received from 446 women, constituting 13% of the antenatal population of Cornwall. Their median age was 28 years and median gestation 22 weeks; 255 (57%) had one or more children and 289 (65%) were married. The most popular choice of description was 'patient' (39% of first choices made), whereas the most accepted description was 'pregnant woman' (26% of totalled second and third choices). While women who selected 'patient' as first choice were slightly younger (mean 27.5 years) than the remaining women (mean 28.4 years), the choice of 'pregnant woman' was not related to any of the other recorded characteristics of the respondents. Commercial terms that consistently were selected least included 'client', 'consumer' and 'customer'. CONCLUSION: Some professional bodies and government organisations have criticised the use of the term 'patient' to describe antenatal women. In this, the largest study to investigate what the women themselves would choose, 'patient' is the most favoured term.
Asunto(s)
Embarazo/psicología , Atención Prenatal , Terminología como Asunto , Adolescente , Adulto , Actitud Frente a la Salud , Estudios de Cohortes , Estudios Transversales , Femenino , HumanosRESUMEN
OBJECTIVE: To determine the risk of recurrent cervical intraepithelial neoplasia (CIN) in women with complete or incomplete excision of cervical intraepithelial neoplasia treated by large loop excision of transformation zone (LLETZ). DESIGN: A retrospective study SETTING: One consultant-led colposcopy clinic at Leicester Royal Infirmary POPULATION: Three hundred and ninety-four women referred consecutively to the colposcopy clinic between 1991 and 1992. MAIN OUTCOME MEASURES: The histological recurrence rate of CIN, length of cytological follow up following treatment related to degree of completeness of excision at initial treatment. RESULTS: Three hundred and twenty-two women had complete cytological or histological follow up. The mean length of follow up was 73 months with a mean number of six smears. Women with incomplete excision of CIN had a significantly higher risk of recurrent CIN (relative risk 8.23) occurring in a significantly shorter time compared with women with complete excision. CONCLUSIONS: This study demonstrates that large loop excision of transformation zone is successful in over 95% of cases. Cytological surveillance is satisfactory for follow up of women who have complete excision of CIN. Women with incomplete excision of CIN at initial LLETZ remain at significant risk of developing further CIN and long term colposcopic and cytological follow up is necessary.
Asunto(s)
Recurrencia Local de Neoplasia/etiología , Complicaciones Posoperatorias/etiología , Displasia del Cuello del Útero/cirugía , Neoplasias del Cuello Uterino/cirugía , Adolescente , Adulto , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Neoplasia Residual , Estudios Retrospectivos , Factores de Riesgo , Neoplasias del Cuello Uterino/patología , Displasia del Cuello del Útero/patologíaRESUMEN
A follow-up study of 178 adult patients with primary inguinal hernia repair revealed significantly fewer recurrences after the McVay operation for a pure direct hernia than for a pure indirect hernia. The recurrence rate for pure indirect hernias was 19.3 +/- 4.3 per cent after ten years and 20.7 +/- 4.6 per cent after 15 years. The mean observation time was 11 years, 98 patients. The recurrence rate for pure direct hernias was 4.1 +/- 2.8 per cent after ten years and 7.5 +/- 4.5 per cent after 15 years. The mean observation time was 13 years, 52 patients. Twenty-eight patients treated for a pure indirect hernia with a simple abdominal ring repair had no recurrences after a mean observation time of ten years. We suggest that the reason for the higher recurrence rate among patients treated with a McVay repair for an indirect inguinal hernia might be due to the interference with the healthy posterior wall of the inguinal canal, since 50 per cent of the recurrences in this group were direct. It is stressed that abdominal ring repair should be the treatment of choice for indirect hernias.
Asunto(s)
Hernia Inguinal/cirugía , Adolescente , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Métodos , Persona de Mediana Edad , RecurrenciaAsunto(s)
Hernia Inguinal/cirugía , Estudios de Seguimiento , Humanos , Métodos , Recurrencia , Estadística como AsuntoRESUMEN
Aplasia cutis congenita is a rare disease with less than 300 cases reported in the literature. A patient with extensive involvement of the skin was observed for 25 years. During adolescence, a reactive depression related to the residual cicatricial alopecia on the left side of the scalp developed. The psychiatric distress disappeared after corrective surgery was performed. It is recommended that patients with this disorder be regularly observed to select cases appropriate for early plastic surgery.